The Daily Editors' Blog

Catching the wave: It's becoming easier to get a professional band at your nursing home

Less than a year ago, Gary Gamponia and his benevolent bandmates broke onto the national scene with a McKnight's blog entry about the way they play concerts at nursing homes for free. Boy, is it time for an update.

Valley fever 'epidemic': advice for providers

The senior citizen population is on the rise in the Southwest. Unfortunately, so is a frightening illness: valley fever.

The real key to keeping employees well

Many long-term care operators have begun to put wellness programs in place. And by most accounts, they seem to be working out well so far. But do wellness programs really work? The short answer appears to be that we don't know.

Senior living operators can choose happiness — which really annoys some economists

In recent times, federal deficit spending has only gotten worse. But now that it appears there are some bright spots, it's a bad thing? Depends on whom you talk to.

There's no place like the county nursing home

Whether you are an employee, resident, citizen or member of another group, you can learn from the lessons I've learned while exhaustively investigating a story about running and saving county nursing homes in America.

Long-term care providers ready to deal with 'doc fix'

If you hang around long enough, you learn there are only two things long-term care providers fear after Republicans and Democrats. That would be hospitals and doctors.

'Today is Sunday' describes the challenges, uplift of long-term care

The "For Sale" sign outside my grandmother's house caught me by surprise last Saturday.

This unfavorable worker's comp ruling is a real Croc

We're hearing a lot lately about mandatory drug testing in the workplace. It appears that the Tennessee Supreme Court might be a good place to put such a requirement in place. The state's highest court recently upheld a bizarre worker's comp claim against a skilled care operator that defies logic, common sense, and perhaps even the law.

Latest Medicare fraud allegations just an appetizer

As we've been predicting here for some time, allegations of mismanaged therapy care are starting to land nursing homes in some seriously hot water.

Tackling resident-on-resident abuse

While at a post office recently, I watched a woman cut in line to demand the clerk fix the automated posting machine. A fight broke out between her and the man at the front of the line: Voices were raised, threats were issued and I kept my hand on my phone, waiting to dial 911 if violence erupted.

Unions scowl, employers beam. Just what do employees need to know?

First of all, to all the pro-union and pro-management types: Thanks for reading. Too bad only one of you can be happy after Tuesday's federal appeals court ruling that tossed a National Labor Relations Board decree. But it ought to be that way.

CPR in nursing homes: The debate turns upside down under

Intrepid Daily Show correspondent John Oliver recently headed Down Under. His assignment: Find out how Australia's strict gun control measures have played out since being passed in the mid-1990s. It occurred to me that Oliver might be able to repeat this trip in the future, only instead of reporting on Aussie gun control, his subject might be the country's move away from CPR in nursing homes.

A chance to make your staff very, very happy

It's your turn to risk having an excited staff. Starting today, the second annual McKnight's Excellence In Technology Awards program is officially underway.

It's a struggle to survive in long-term care, and maybe that's a good thing

We live in a nation that worships people associated with success. We tend to name buildings, highways and even states after such high-level achievers. Perhaps rightfully so. They are the few who show the rest of us what the so-called right stuff is all about.

Ducking the federal budget issue

The years of cuts to federal scientific grants has been a travesty, and I don't use that word lightly. The often-mocked duck reproduction project is an example of putting a small amount of money to fund basic scientific knowledge.

Looking to open eyes about 'observations'

Bully for provider groups pulling out the stops to draw attention to the ludicrous mishandling of "observation stay" designations by many hospitals. One prong of the plan is to have providers supply anecdotes about individuals hurt financially and emotionally by the practice.

The easiest rule to break in long-term care?

If you work in long-term care today, you might feel like you're drowning in an alphabet soup of possible deficiency ratings. So forgive me, but let's imagine there's yet one more possible citation to watch out for: the GR.

Yes, Medicaid caps really are a terrible idea

OK kids, time for an unannounced pop quiz. Here goes: How do Medicaid caps differ from New Coke, Sarbanes-Oxley and hands-free lawnmowers? The other three bad ideas were actually carried out

Cameras in nursing homes? Better get used to them

Street cameras played a major role in identifying the two brothers who allegedly bombed the Boston Marathon. In the wake of this helpful development, public support is growing for expanded use of cameras in high-congestion areas.

"Life After Life" may be your life

Behold, readers: There's a new work of literary fiction that takes place in a long-term care facility.

Green House in our midst

I almost feel like I'll need to find a confessional booth after completing this blog post. I come not to bury the Green House project but to praise it. This is tough to do.

When keeping thousands costs millions

As any retailer will tell you, advising customers to shop elsewhere is never easy. Yet that is exactly what too many senior living operators should be doing - but won't.

Pssst, here's how the LTC lobby can eliminate the 3-day rule — and gain other Congressional perks

You might not be old enough to remember the "Schoolhouse Rock" videos that aired between cartoons on Saturday mornings during the 1970s. One of my favorites was "I'm Just a Bill." Long-term care novices could learn a lot from it — to a point.

What the family wants

When it comes to talk about palliative care and rehospitalizations, what should a provider do when the family is insistent on sending their loved one back to the hospital?

Nurses gaining power ... LTC style

How could we not see it coming? That's the question I asked myself Tuesday.

Of Purell and payment reform

I was sympathetic when the Partnership for Sustainable Health Care called for a speedier shift away from fee-for-service last week — and I also thought about Purell. Yes, that Purell.

Many LTC operators avoiding path to greatness?

Billionaire Warren Buffet famously once said he had two rules for investing. The first was to make money. The second was to remember the first.

Say the right thing

When my mother was undergoing treatment for breast cancer around 15 years ago, a good friend of hers would call and start crying.

Hoping for some 'observation stay' sanity

It was welcome news Tuesday to learn that the confirmation hearing for the person who could officially wind up holding the purse strings for most nursing home payments was civil. Even better was the nominee saying she would look into the ridiculous state of affairs concerning hospital observation stays.

The secret to success: Take it easy

Attention all strivers and overachievers. You should slow down and not push yourself too hard, two new studies suggest.

You call these nursing home secrets?

Reader's Digest magazine recently published an article called "50 Secrets a Nursing Home Won't Tell You." I'm a bit dismayed by the lack of evidence that's actually presented.

Immigration reform won't solve long-term care's fundamental staffing challenge

Long-term care operators are understandably giddy about the sudden prospect of immigration reform. But they might want to curb their enthusiasm.

Will there be a 'real' CMS administrator soon? It's looking so

If you're a gambling person, it looks like the odds just got a whole lot better for Marilyn Tavenner becoming the next administrator of the Centers for Medicare & Medicaid Services. That's the person who manages the main funding streams of long-term care in the United States.

The power of thank you

Have you thanked anyone at work today? If you have, you've done something very powerful.

It's easy to forget how quickly things have improved for LTC

This publication and this sector were facing some very troubled times in 1990. That's when I joined McKnight's Long-Term Care News. The experts have a technical term for where the field and the magazine were at that time: barely alive.

Cancer survivors pose challenges and opportunities for long-term care

One of the occupational hazards of being a journalist is that you often have to distribute bad news. But every so often you get to share something that's a bit more cheerful. This is one of those times.

A study that may never be done — but should

Government agencies and lobbyists are famous for conducting studies that prove a point — theirs, namely. That's why I'll be very interested to see who will have the courage to conduct one of the most important long-term care-related studies that should be completed over the coming year.

Stop making excuses

In healthcare, there's a knee-jerk fear that admitting a mistake or error in judgment will lead to a lawsuit, and so an excuse is made. While it's important to hear someone out as to their reasoning for, say, a resident care plan, there is a difference between explanation and excuse.

The long-term care jackal: Not just a bad dream

We must change the conversation around long-term care, dispelling myths and encouraging people to speak frankly and plan realistically for the needs of people as they age.

Sector fundamentals are improving, really

There are some tangible signs that things are getting better for the senior living sector, and probably for the overall economy as well.

Shamelessly invoice at your own risk

Here's the good news for providers: new analytics are making it possible to understand and bill your care in ways that would have been impossible just a few years ago. Here's the bad news: The government is quite aware of these new options.

Thinking like a hospital

A provider conference session this week was called "Using War Games to Cope in Uncertain Times." Its subtitle could have been "Act Like a Long-Term Care Organization, Think Like a Hospital."

Life expectancy: A reason to wipe that smile off your face

Even after a few weeks, it still seems like a bad joke. Maybe something pulled from the front page of The Onion, the satirical newspaper that has been lampooning revered subjects for years.

Who these people are: Nursing home care for Vietnam vets

Here's a conundrum: The rate of post-traumatic stress among Vietnam veterans has climbed from already high levels in recent years, with the 9/11 attacks and the Iraq War serving as triggers. This potentially increases the caregiving burden on families as these veterans age, and increases veterans' need for long-term care.

Managed care: Panacea, death knell or something in between?

In a nutshell, troubled long-term care operators seem to be encountering this scenario with managed care companies: initial romance, followed by heightened accountability and reduced payments.

Frisky Alzheimer's residents: 'ew' or 'aw'?

Alzheimer's disease is very good at taking. It takes away memories. It takes away personalities. It can be argued that Alzheimer's essentially takes away a person's essence. And as almost anyone who has spent time in a senior living facility can tell you, it can also take away sexual inhibitions.

Vitamin D for dummies

It's not a secret that employees who work in healthcare, whether they are medical journalists or nurses, don't always earn gold stars when it comes to managing their own health. Witness the nurses clustering in a "butt hut" outside a facility, an administrator taking a cavalier approach to his or her diet, or saleswomen wearing sole-killing heels at a conference.

Power to the people? That could mean trouble

There are plenty of legal concerns that keep nursing home administrators awake at night. Many times, the demons can be kept under the bed or locked in the closet. But not always.

Before the frat party, the nursing home

Some of us could live to be 150.

When long-term care experts speak, things can get foggy

I was hoping to get clear answers about the sector's future at the National Investment Center for the Seniors Housing & Care Industry's regional meeting last week in San Diego. I did, but I also must admit there were times when it was hard to give the various speakers the attention they deserved.

Message from the White House: Don't trust nursing homes

Ever wonder how much regard the White House has for long-term care operators? A brief filed last week makes the answer abundantly clear: very little.

The myth of CPR

The international attention over the incident concerning an independent living facility's refusal to give CPR, as a matter of policy, has inspired a lot of clutching of pearls regarding long-term care's medical ethics. There were a few big facts that got left out of the original reporting.

The easy way to get LTC experts into your office

Nobody should pass up the opportunity to have a nationally respected professional expert visit his or her office. The chance to get six in there in a short amount of time? Outrageous. Yet, it's going to happen.

Is 'murse' OK? Tips for gender integrated nursing staffs

McKnight's Senior Editor Elizabeth Newman recently raised some thought-provoking questions about how "women manage women" in long-term care facilities with largely female staffs. Her blog got me thinking along some other lines as well: Male-female and male-male conflicts may become increasingly common as skilled nursing facilities become more gender diverse.

Is 'murse' OK? Tips for gender integrated nursing staffs

McKnight's Senior Editor Elizabeth Newman recently raised some thought-provoking questions about how "women manage women" in long-term care facilities with largely female staffs. Her blog got me thinking along some other lines: Male-female and male-male conflicts may become increasingly common as skilled nursing facilities become more gender diverse.

LTC insurance adjustment: Smart business move or blatant sexism?

There's an adage about insurance coverage: While the big print giveth, the small print taketh away. Genworth Financial — one of the nation's largest long-term care insurance carriers - is giving the phrase a new twist.

Catfight on the SNF floor

Let's pretend that you work in a facility or company with mostly female employees. I know, it's a stretch. When conflicts arise between two women, what do you think?

Resident who tried to murder assisted living supervisor escapes prosecution

The 87-year-old man who said he tried to kill an assistant living supervisor because he felt "bullied" will not be prosecuted for shooting the long-term care employee once in the stomach.

Resident or inmate, or both?

Is it a nursing home ... or a prison? That sounds like a shady lawyer trolling for clients, but it's an urgent question for the residents of Rocky Hill, CT. And it may be a pressing question for communities across the country in the near future.

For long-term care operators, safe bets can be anything but

If there's one thing long-term care operators contemplating the coming years should know by now, it's this: There are no guarantees. That's worth keeping in mind as various can't-miss strategies that ensure future success are being pitched your way.

Why long-term care operators are wary - and weary - of sequestration fiasco

Well, here we go again. Less than three months after President Obama and Congress narrowly avoided walking off a fiscal cliff, we're bracing for Round 2. Only this time, we're all a bit worse for wear.

Excellence advancing

If it were the stock market, the climb would indicate a lot of people becoming quite wealthy. Instead, its significant rise will have to settle for merely making a lot of people more healthy.

Tuesdays with Kathy

Amour isn't just a movie about an elderly couple. It also thoughtfully provokes questions about how families interact when confronted with long-term care situations. It also raises questions for caregivers.

Is this the year therapy caps finally get repealed? Probably not

Earlier this week, we saw lawmakers again take aim at Medicare's outpatient therapy caps. Rightfully so. Therapy caps are a dubious idea that ought to be given a decent burial.

Frail or sturdy? Seniors decide what they want to be

If you're like me, you're a big believer in the saying "Attitude determines altitude." If you're in the eldercare business, this should become embedded in your mind — for the good of those on your watch.

Happy February

February seems like an appropriate month to ask the fundamental question: What does it take to be happy?

A toxic nursing home strike that gets weirder by the day

The late Hunter S. Thompson famously said that when the going gets weird, the weird turn pro. By his logic, the management and workers involved in a strike across five HealthBridge Management facilities in Connecticut seem to be taking professionalism to a whole new level.

Proposed law could raise labor costs for long-term care operators

Many a provider broke out in cold sweats when the Family and Medical Leave Act was cobbled together two decades ago.

Who will be pronounced the bad guy in this nursing home crime?

The news flashed across my screen and immediately I said to myself, "This type of headline could be very bad for nursing home operators ... or maybe just kind of bad."

Robots for hire

In the roundup of best Super Bowl commercials, the one that best relates to your lives didn't air. No, I'm not talking about the elderly people escaping from the nursing home to go eat Taco Bell, although I'm sure that's something that keeps your security people up at night. Or the Clydesdale: Brotherhood commercial, my personal favorite even though it makes me cry every time I watch it.

Is the National Football League our best hope for Alzheimer's progress?

More than 110 million Americans watched yesterday's Super Bowl in New Orleans. It's not too hard to see why the game has become our nation's defining cultural ritual. The National Football League also could give us the nation's best chance at progress against Alzheimer's disease.

Successful new ancillary service for long-term care operators? No, a bad trick

It is no secret that long-term care operators and other senior care providers love a good, money-making ancillary service to take care of their residents and firm up the bottom line. That's one reason why hot nursing home "news" out of Britain this week might have actually had some long-term care stakeholders excited at first blush.

The laying on of paws

Around 4 a.m. a few nights ago, I woke up feeling miserable. As I curled up back in bed after taking some meds, one of my cats hopped up next to me, looked at me with concern and laid a paw atop my arm.

More evidence that long-term care operators are not simply heartless bottom feeders

What matters most to long-term care operators? Certainly, remaining in business is a top priority. But providers are not just fixated on the bottom line. Here are some telltale signs.

This pilot long-term care program might require actual pilots

The Centers for Medicare & Medicaid Services often backs pilot programs that might help improve long-term care services. In recent years, the agency has funded efforts to do things such as update employee background checks, reduce pressure ulcers, improve e-prescribing, and foster at-home independence.

Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Senior Editor Elizabeth Newman on Tuesday; and Editor James M. Berklan on Wednesday.

    Contributors

    James M. Berklan
    Editor

    James M. Berklan

    Elizabeth Leis Newman
    Senior Editor

    Elizabeth Leis Newman

    John O'Connor
    Editorial Director

    John O'Connor

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